27 May 2025
: Case report 
Diagnosis and Management of Autoimmune Hepatitis After Hepatitis A in a Young Woman
Challenging differential diagnosis, Unusual setting of medical care, Rare disease
Siddharth Patel
ACDEF 1*, Cory Dixon AEF 2, Niti Chokshi EF 3, Susana Giraldo AEF 2, Mrudula Thiriveedi E 1, Virginia Dailey E 4
DOI: 10.12659/AJCR.946795
Am J Case Rep 2025; 26:e946795
Table 1 Laboratory investigations performed on admission and during hospital stay.
| Patient values | Reference values | |
|---|---|---|
| WBC | 5.16 | 4.8–10.8×1000 cells/microL |
| RBC | 4.52 | 4.2–5.4×MIL cells/microL |
| Hgb | 14.5 | 8.7–11.2 mmol/L |
| Hct | 42.4 | 37.0–47.0% |
| MCV | 93.8 | 81–99 FL |
| MCH | 32.1 | 27–31 PG |
| MCHC | 34.2 | 33–37 g/dL |
| RDW Std deviation | 13.5 | 11.5–14.5% |
| Platelet | 141 | 130–400×1000 cells/microL |
| MPV | 11.5 | 7.4–10.4 FL |
| Neutrophils% | 67 | 42.2–75.2% |
| Lymphocytes% | 23.1 | 20.5–51.5% |
| Monocytes% | 8.5 | 1.7–9.3% |
| Eosinophils% | 0.6 | 0.0–10.0% |
| Basophils% | 0.03 | 0.0–0.8% |
| Sodium | 135 | 135–145 mmol/L |
| Potassium | 3.8 | 3.5–5 mmol/L |
| Chloride | 99 | 98–105 mmol/L |
| Calcium | 9.6 | 8.8–10.2 mg/dL |
| Carbon dioxide | 24 | 25–35 mmol/L |
| Blood urea nitrogen | 8 | 3.6–7.1 mmol/L |
| Serum creatinine | 8.4 | 44–97 μmol/L |
| Direct bilirubin | 4.9 | 0.00–0.02 mg/dL |
| Total bilirubin | 6.4 | 0.20–1.00 mg/dL |
| Aspartate transaminase | 771 | 10–30 U/L |
| Alanine transaminase | 1249 | 10–36 U/L |
| Alkaline phosphatase | 282 | 32–104 U/L |
| Ammonia | 26 | 11–51 umol/L |
| C-Reactive protein | 10.43 | 0.0–0.5 mg/l |
| Total protein | 8 | 6.3–8.3 g/dL |
| Albumin | 4.5 | 3.5–5.0 g/dL |
| Triglycerides | 162 | 35–135 mg/dL |
| Glucose | 83 | 70–104 mg/dL |
| Hb A1C | 5.1 | 4.8–6.0% |
| Hepatitis profile | Non-reactive | Non-reactive |
| Hepatitis A Ab, total | Positive | Unvaccinated – negative; Vaccinated – positive |
| Anti-smooth muscle Ab titer, S | Positive 1: 160 | Negative |
| Anti-nuclear Ab screen | Positive | |
| Alpha-1 antitrypsin | 163 | 100–190 mg/dL |
| Anti-mitochondrial Ab | <0.1 | <0.1 U |
| AFP tumor marker | 7 | 0–8.7 ng/mL |
| Ceruloplasmin | 27.5 | 20–51 mg/dL |
| Liver/Kidney microsome type | <0.5 | ≤20 U |
| Cytomegalovirus Ab IgM | Negative | Negative |
| Cytomegalovirus Ab IgG | Positive | Negative |
| Ova and parasite results | None seen | Negative |
| Blood culture | No growth | Negative |
| Urine culture | No growth | Negative |